Certificate of Liability Insurance

Date Issued: 10-13-2018

Underwritten by: Philadelphia Indemnity Insurance Company · One Bala Plaza, Suite 100 · Bala Cynwyd, PA 19004 · NAIC #: 18058
Administered by: CPH & Associates · 711 S. Dearborn St. Ste 205 · Chicago, IL 60605 · P 800.875.1911 · F 312.987.0902 · info@cphins.com

DISCLAIMER: This certificate is issued as a matter of information only and confers no rights upon the certificate holder. The Certificate of Insurance does not
constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend,
extend, or alter the coverage afforded by the policies listed thereon.

Insured: Armirah Stephens Policy Number: AR76531

604 S High St Policy Term: 08/31/2018 to 08/31/2019
Franklin, VA 23851 Occupation: AAMFT Student

Covered Locations
Professional Liability: Portable coverage, not location specific
Coverage Type Per Incident Aggregate
(Occurrence Form) (Per individual claim) (Total amount per year)
Professional Liability $ 1,000,000 $ 3,000,000
Supplemental Liability $ 1,000,000 $ 3,000,000
Licensing Board Defense $35,000 $35,000
Commercial General
N/A N/A
Liability
N/A N/A
▫ Fire/Water Legal Liability
Business Personal Property N/A N/A
Comments/Special Descriptions:

Certificate Holder

PROOF OF COVERAGE

If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in
lieu of such endorsement(s). Notice of Cancellation will only be provided to the first named insured in accordance with policy provisions, who shall act on behalf of all
additional insureds with respect to giving notice of cancellation.

Authorized Representative
C. Philip Hodson